Lower Limb Lymphedema Common in Survivors of Gynecological Cancer

NEW YORK JUN 27, 2007 (Reuters Health) - A significant proportion of gynecological cancer survivors develop lower limb lymphedema, according to results of a study published in the June 15th issue of Cancer.

"Lower limb lymphedema is one of the most disabling side effects of surgical and radiotherapy treatment for gynecological cancer," note Dr. Vanessa Beesley, of the Queensland Institute of Medical Research, Australia, and colleagues.  "For many gynecological cancer patients, lymph node dissection is an integral part of cancer treatment and surgical staging, and this procedure has been associated with lymphedema development."

The researchers conducted a population-based cross-sectional mail survey of gynecological cancer survivors in 2004.  The questionnaire, which was completed by 802 women, included items on demographics, supportive care needs, and lymphedema-related needs.

Overall, 10% of subjects reported a diagnosis of lymphedema.  Another 15% reported undiagnosed symptomatic lower leg swelling.  The prevalence of diagnosed lymphedema was higher among survivors of vulvar cancer (36%) than all other gynecological cancer subgroups.

Multivariate analysis revealed that for cervical cancer survivors, the odds of developing lower limb swelling were 3.5 times higher if they had radiotherapy and 3.3 times higher if they had lymph nodes removed.  The odds of developing lymphedema were higher for survivors of uterine and ovarian cancer who had lymph node dissection or who were overweight or obese.

"Whereas 31% reported being informed about lymphedema before their cancer treatment, 34% of women did not recall being informed about this condition until they were diagnosed," Dr. Beesley and colleagues report.  "Others (30%) were informed after their cancer treatment but before symptoms arose, or they could not remember when they were informed (5%)."

The researchers note that supportive care needs in the information and symptom management domains were higher in gynecological cancer survivors with lymphedema than in those with no swelling.

"Women at risk for lymphedema would benefit from instructions about early signs and symptoms and provision of referral information," the team concludes.

SOURCE:

• Cancer 2007;109:2607-2614.